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                The most cost-e?ective screening test for determining HIV status is which of the following?

                Western blot

Enzyme-linked immunosorbent assay Venereal Disease Research Laboratory test Viral load




Question 2.         Which blood test is a nonspecific method and most helpful

for evaluating the severity and course of an inflammatory process?

                Erythrocyte sedimentation rate

White blood cell count Polymorphonuclear cells


C-reactive protein (CRP)






Question 3.         Cocaine acts as a stimulant by blocking the reuptake of

which neurotransmitter?

                GABA Acetylcholine Dopamine Serotonin




Question 4.         Mrs. Thomas was seen in the o?ce complaining of pain and

point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that di?erentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

                                Ecchymosis, edema, and erythema over the lateral epicondyle

   Pain at the elbow with resisted movements at the wrist

and forearm

Inability to supinate and pronate the arm

Inability to flex or extend the elbow against resistance



Question 5.         Which of the following statements concerning the

musculoskeletal examination is true?

                                  The uninvolved side should be examined initially and then compared to the involved side.

   The part of the body that is causing the patient pain should be examined first.

When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.

Radiographs should always be obtained prior to

examination so as not to cause further injury to the patient.




Question 6.         Which of the following signs or symptoms indicate an


inflammatory etiology to musculoskeletal pain?

                Decreased C-reactive protein

Hyperalbuminemia Morning sti?ness Weight gain




Question 7.         Which causes the greatest percentage of mammalian bites?

                                  Dogs  Cats

   Humans  Rodents




Question 8.         A 48-year-old woman is seen in the clinic with complaints of

prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first?

                Transvaginal ultrasound

Endometrial biopsy MRI

Abdominal computed tomography scan               



Question 9.         A diabetic patient asks the clinician why he needs to check

his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?

                "Control of glucose will help postpone or delay


"Regularly checking blood sugar will help establish a routine."

"Monitoring glucose will promote a sense of control."

All of the above                 


Question 10.      A 25-year-old patient presents to the clinic with fatigue, cold


intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular sti?ness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?

                Serum calcium TSH


Urine specific gravity       

Question 11.      Which of the following medications for type 2 diabetes

mellitus should not be prescribed during pregnancy?

                Insulin Metformin Glucotrol Precose




Question 12.      During a DRE on a 75-year-old man, the clinician suspects

the patient has prostate cancer. What physical finding should make the clinician suspicious?

                An enlarged rubbery gland

A hard irregular gland A tender gland

A boggy gland     

Question 13.      Eddie, age 4, presents to the ED with a live insect trapped in

his ear canal causing a lot of distress. What should be your first step?

                Remove the insect with tweezers.

Immobilize the insect with 2% lidocaine. Sedate Eddie with diazepam.

Shine a light in the ear for the insect to "find its way out."            



Question 14.      What is the most common cause of microcytic anemia?

                Anemia of chronic disease

Sideroblastic anemia Iron-deficiency anemia Thalassemia




Question 15.      An 82-year-old man is seen in the primary care o?ce with

complaints of dribbling urine and di?culty starting his stream. Which of the following should be included in the list of di?erential diagnoses?

                Benign prostatic hyperplasia (BPH)

Parkinson's disease Prostate cancer

All of the above                 

Question 16.      Early rheumatoid disease is characterized by:

                                Pain and swelling in both small and large peripheral joints

Rigid joints with diminished range of motion

Joint swelling and immobility on rising A cardiac rub or pulmonary friction rub




Question 17.      A 70-year-old female has fallen 2 weeks ago and developed

immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do?

                                  Make an immediate referral for an orthopedic evaluation without further assessment.

   Tell her that it takes time for these bruises to improve, so she should be patient.

Obtain a wrist x-ray and place her wrist in a splint or


prescribe a splint.

   Send her to the emergency room for reduction of this obvious wrist fracture.




Question 18.      The criteria for diagnosing generalized anxiety disorder in

the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

                1 month 3 months

6 months

12 months   

Question 19. A 60-year-old man presents with an enlarged scrotum. The

clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

                The scrotum will be dark.

The scrotum will appear light pink or yellow. The scrotum will appear milky white.

The internal structures will be clearly visible.




Question 20.      According to Kübler-Ross, the stages of grief occur in which


                Anger, denial, depression, bargaining, acceptance

Anger, denial, bargaining, acceptance, depression Denial, anger, depression, bargaining, acceptance Denial, anger, bargaining, depression, acceptance




Question 21.      Reuben, age 24, has HIV and just had a routine viral load

test done. The results show a falling viral load. What does this indicate?

                  A favorable prognostic trend


Disease progression

The need to be more aggressive with Reuben's medications

   The eradication of the HIV




Question 22.      The exanthem of Lyme disease is:                           Erythema infectiosum

Laterothoracic exanthem Erythema migrans Morbilli exanthem




Question 23.      You have detected the presence of crepitus on examination

of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

                Articular Inflammatory Nonarticular A and B




Question 24.      What is the recommended daily calcium intake for adults

over the age of 50 with low bone mass?

                1,200 mg/day 1,000 mg/day

1,300 mg/day

1,500 mg/day      

Question 25.      When assessing a woman for infertility, which of the

following tests should be done first?

                Analysis of partner's sperm

Magnetic resonance imaging (MRI) Hysterosalpingogram


   Estrogen level                 

Question 26.      Which type of burn injury results in destruction of the

epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

                  Superficial burns

   Superficial partial-thickness burns   Deep partial-thickness burns

   Full-thickness burns      

Question 27.      A 23-year-old sexually active woman presents for her first

Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?

                Human papillomavirus (HPV)

Endometrial hyperplasia Vagismus

Polycystic ovarian syndrome      



Question 28.      As a rule of thumb, the estimated level of hematocrit is how

many times the value of the hemoglobin?

                Two Three Four Five




Question 29.      Sam is a 25-year-old who has been diagnosed with low

back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?


                Morning sti?ness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

   Fever, chills, and elevated erythrocyte sedimentation rate

   Pathologic fractures, severe night pain, weight loss, and fatigue





Question 30.      A 30-year-old man is seen with a chief complaint of loss of

libido. Which of the following laboratory tests would help establish a diagnosis?

                Testosterone level Prostate-specific antigen

Nocturnal penile tumescence and rigidity Prolactin level




Question 31.      The clinician prescribes glipizide (Glucotrol) for a diabetic

patient. Which statement made by the patient would indicate that your teaching has been e?ective?

                "I'll take my pill at least 30 minutes before breakfast."

"I'll take my Glucotrol before bedtime."

"It is important to take my medication right after I eat." "Since I only like to eat two meals a day, I can take the pill

between my meals."     



Question 32.      In the United States, what is the second most common

connective tissue disease and the most destructive to the joints?


Systemic lupus erythematosus (SLE) Rheumatoid arthritis

Sjögren's syndrome         


Question 33.      The e?ectiveness of benzodiazepines in treating anxiety

disorders suggests that which of the following neurotransmitters plays a role in anxiety?


   Gamma-aminobutyric acid (GABA)   Dopamine


Question 34. A 14-year-old male is seen with complaints of severe

testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?

            Refer to a urologist immediately.

   Obtain a computed tomography (CT) scan.   Instruct the patient to elevate the scrotum.   Prescribe ibuprofen.




Question 35.      Which of the following medications can cause


                Prednisone Metformin Synthroid Cephalexin




Question 36.      During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?



Upper lateral thigh Deltoid




Question 37. It is important to educate patients with depression and their

family members about reporting signs of increasing depression and suicidal thoughts. This is especially true


during which time period?

                Before the initiation of treatment

1 to 2 weeks after the initiation of treatment When switching to a di?erent medication

1 to 2 weeks after tapering o? medications





Question 38.      What is the most common cause of secondary amenorrhea?


Pituitary dysfunction Inadequate estrogen levels Genetic disorders




Question 39.      Which of the following is the only drug for bulimia approved

by the U.S. Food and Drug Administration?

                                  Sertraline  Fluoxetine  Citoprolam   Imipramine




Question 40.      The goals of the 15-minute hour approach include:                          Enhance self-esteem, expand behavioral repertoire,

prevent dire consequences, and reestablish premorbid levels of functioning

   Emerge with a higher level of functioning and commitment to long-term psychotherapy

   Accept need for antidepressant therapy and psychiatric referral; share concerns with primary care clinician

Improve family functioning and sexual performance as well as accept need for antidepressant medication




Question 41.      John is a 16-year-old boy who presents to the emergency

room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it


completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

                Valgus stress test

McMurray circumduction test Lachman test

Varus stress test               

Question 42.      The cardinal subjective symptom of sickle cell crisis is which

of the following?

                Pain Nausea

Light-headedness Palpitations




Question 43.      A 25-year-old woman is seen in the clinic complaining of

painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea?

                Pelvic inflammatory disease


Sexually transmitted infections Ovarian cyst




Question 44.      Which arthropod bite can contain cytotoxic and hemolytic toxins that may destroy tissue?


Brown recluse spider Wasp

Stinging caterpillar            


Question 45.      Janet is a 30-year-old who has recently been diagnosed with


a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

                  Gastrocnemius  weakness

   A reduced or absent ankle reflex   Numbness in the lateral foot

   Paresthesia of the perineum and buttocks       



Question 46.      A 21-year-old woman is seen in the clinic requesting birth

control pills. Which of the following tests is essential before prescribing any oral contraceptive?

                  Pregnancy test

   Complete blood cell count   Thyroid-stimulating hormone   Urine dip for protein




Question 47.      A patient with type 2 diabetes comes to the clinic after

reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?

                Ketoacidosis Cirrhosis

Hypoglycemic episodes All of the above




Question 48.      The clinician has chosen to prescribe an SSRI instead of a

tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

                SSRIs are more e?ective than TCAs.

SSRIs take less time to work than TCAs.

SSRIs have a more favorable side-e?ect profile than TCAs.

SSRIs are not lethal in overdose.





Question 49.      Which type of bone marrow transplant is obtained from an

identical twin?

                Autogenic Autologous Allogeneic Syngeneic




Question 50.      Pink, cherry red tissues and skin may result from which type

of poisoning?

                Arsenic Lead

Carbon monoxide Strychnine




Question 51.      Basic human needs are identified as:                      Autonomy and feeling valued by others

Exhilaration and productivity Spirituality

Career success and material rewards     



Question 52.      The clinician sees a patient who is 5 feet tall and weighs 150

pounds. How would the clinician classify this patient?

                Overweight Mild obesity

Moderate obesity Morbid obesity




Question 53.      A 22-year-old male is seen in the clinic because he found a

hard lump in his testicle when performing testicular self-


examination (TSE). Which of the following should be included in the list of di?erential diagnoses?

                Testicular cancer Inguinal hernia Varicocele

All of the above                 

Question 54.      What is the treatment of choice for a patient diagnosed with

testicular cancer?

                Radical orchidectomy

Lumpectomy Radiation implants All of the above




Question 55.      Which method is used to remove heavy metals, such as

lead, that are ingested as poisons?

                Chelation Dialysis Gastric lavage

Bowel irrigation                 

Question 56.      A 58-year-old woman presents with a breast mass. Which of

the following responses by the clinician would be most appropriate?

                "It is probably just a cyst because that is the most

common breast mass."

"We will order a mammogram and ultrasound to help establish a diagnosis."

"We will go ahead and schedule you for a biopsy because

that is the only way to know for sure."

   "Because your lump is painful, it is most likely not cancer."




Question 57.      A 36-year-old woman is seen with complaints of vaginal

itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?


   Estrogen vaginal cream   Metronidazole


Question 58.      The clinician has instructed Sam, a 25-year-old patient with

low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

                                "You should start with the lowest dose that is e?ective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage."

   "You should start with the lowest dose that is e?ective in managing your pain to avoid developing tolerance to the medication."

"You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain."

"It is important to take NSAIDs on an empty stomach in

order to increase absorption."  



Question 59.      A history of overuse or excessive force, as opposed to a fall,

hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury?

                                  A sprain   A strain

   A partial fracture   A fracture




Question 60.      Which type of heat-related illness involves a core body

temperature of at least 104.9°F, acute mental status


changes, absent sweat, and tachypnea?

                                  Heat cramps   Heat syncope

   Heat exhaustion   Heat stroke




Question 61.      Which of the following may be used to evaluate a person's

suicide risk?

                CAGE SANE





Question 62.      One of the initial steps in assessing patients with

musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure?


   Synovium  Tendons  Fascia




Question 63.      After returning from visiting his grandchildren in England,

George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

                A viral syndrome Lyme disease

Rocky Mountain spotted fever Relapsing fever




Question 64.      A patient is diagnosed with hypothyroidism. Which of the


following electrocardiogram changes should the clinician expect as a manifestation of the disease?

                Sinus bradycardia Atrial fibrillation

Supraventricular tachycardia U waves




Question 65.      Which of the following tests is essential for a 46-year-old

woman who the clinician suspects is perimenopausal?

                Pregnancy Estrogen level Progesterone level LH level




Question 66.      After 6 months of Synthroid therapy, the clinician should

expect which of the following in the repeat thyroid studies?

                Elevated TSH Normal TSH Low TSH

Undetectable TSH            

Question 67.      A patient is 66 inches in height, weighing 200 pounds, and

newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment?

                No treatment at this time

Diet and exercise for 6-week trial Diet, exercise, and oral medication Diet, exercise, and exogenous insulin




Question 68.      Which of the following should be considered in a patient

presenting with erectile dysfunction?

                Diabetes mellitus


Hypertension Atherosclerosis All of the above





Question 69.      Mrs. Anderson is a 35-year-old woman who has been

recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome.

Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome?

                                Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

   Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

   Carpal tunnel syndrome only occurs in the presence of a

hormonal imbalance.




Question 70.      A 20-year-old woman is seen in the clinic because her

boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

                Ceftriaxone Doxycycline Acyclovir Metronidazole




Question 71.      Which of the following statements is true regarding the

treatment of carpal tunnel syndrome?

                                  The goal of treatment is to prevent flexion and extension movements of the wrist.

   Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while


maintaining the wrist in a neutral position.

Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.

   All of the above




Question 72.      Mr. S presents in the clinic with pain, tenderness, erythema,

and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient?

                Elevated uric acid level

Elevated blood urea nitrogen Decreased urine pH Decreased C-reactive protein




Question 73.      Which of the following data is indicative of testicular torsion?

                Absent cremasteric reflex

Pain relieved on testicular elevation Testicle very low in the scrotum Swollen scrotum with "red dot sign"




Question 74. A patient with type 2 diabetes asks the clinician why she

needs to exercise. In order to answer her, the clinician must understand that exercise has what e?ect on the patient with type 2 diabetes?

                Reduces postprandial blood glucose

Reduces triglycerides and increases high-density lipoprotein (HDL)

Reduces total cholesterol

All of the above                 


Question 75. A 26-year-old woman is seen with complaints of irregular

vaginal bleeding. Which of the following tests should be the


first priority?

                Pregnancy test Pelvic ultrasound Endometrial biopsy Platelet count




Question 76.      What is the most common cause of generalized

musculoskeletal pain in women ages 20 to 55?

                Chronic fatigue syndrome (CFS) Anemia

Fibromyalgia syndrome (FMS) Sports-related injuries




Question 77.      If the international normalized ratio (INR) result is above the

therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do?

                Stop the warfarin for 1 week, and then repeat the INR.

Withhold one or more days of anticoagulant therapy. Restart therapy at a lower dose immediately.

The prothrombin time and INR should be reevaluated within 1 month of the dosage adjustments.




Question 78.      A 32-year-old woman is seen in the clinic because she has

been unable to get pregnant after 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of these possible causes?

                Pelvic inflammatory disease

Oral contraceptive use for 15 years Early menarche

Diet high in soy protein                



Question 79.      Which of the following statements concerning the treatment


of fibromyalgia syndrome is true?

                                  There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible.

Treatment is directed toward controlling discomfort, improving sleep, and maintaining function.

Fibromyalgia syndrome can be di?cult to manage,

requiring a variety of approaches and multiple medications.   All of the above




Question 80.      The clinician should prescribe an antibiotic that covers

which of these organisms for a patient with acute prostatitis?

                Gram-positive cocci

Gram-negative cocci Gram-positive bacillus Gram-negative bacillus




Question 81.      Which household solution should be used to clean a

bathroom if sharing with a friend who has HIV?

                100% bleach

50% bleach and 50% vinegar Nine parts H2O to one part bleach

The friend must have his or her own bathroom.




Question 82.      Sandra is 42 years old and has just been diagnosed with

leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit?

                Acute lymphocytic leukemia

Acute myelogenous leukemia Chronic myelogenous leukemia Chronic lymphocytic leukemia




Question 83.      Which of the following is identified as an eating disorder in


which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency?


Porter's syndrome Hypochromasia Pica




Question 84.      The clinician suspects that a client seen in the o?ce has

hyperthyroidism. Which of the following tests should the clinician order on the initial visit?

                                High sensitivity thyroid-stimulating hormone (TSH) and free T4

   Free T4 and serum calcium

   Free T3 and T4

   TSH and thyroxin antibodies   



Question 85.      The clinician has been doing diabetic teaching for a patient

with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been e?ective?

                                  "As long as I don't need glasses, I don't have to worry about going blind."

"I know I need to have my eyes checked every year."

"My optometrist checks my eyes."

"I will see my eye doctor when my vision gets blurry."   



Question 86.      Triggering factors for acute exacerbations of which of the

following conditions include exposure to ultraviolet (UV)-B and UV-A rays?

                Rheumatoid arthritis

Scleroderma SLE

Sjögren's syndrome         


Question 87.      Which of the following characteristics separates anaphylaxis

from a vasovagal reaction?


   Extreme diaphoresis

   Severe bronchoconstriction   Hypotension




Question 88.      Mr. Jackson is a 65-year-old man recently diagnosed with

osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility, minimizing disability, and preserving quality of life. Mr.

Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most e?ective in treating osteoarthritis. What would be the most appropriate response from the clinician?

                                "Complementary therapies should be considered only if surgical interventions are not successful."

"I am unfamiliar with the available complementary

therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition."

   "I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy."

   "It would be crazy to use complementary therapies to treat such a serious condition."




Question 89.      One benefit of motivational interviewing (MI) is:

                                It assumes that ambivalence is a normal part of the change process.

   It can be utilized during routine o?ce visits.

   It is a therapeutic technique which is not necessarily time intensive.

   All are benefits of MI.





Question 90.      What percentage of burns is involved using the rule of nines

if both front legs are burned?








Question 91.      Women are at the highest risk for developing postpartum

depression for up to how long after childbirth?

                2 weeks 1 month

3 months

6 months              

Question 92.      Which statement about HIV postexposure prophylaxis (PEP)

for health-care workers is the most accurate?

                PEP should be started within hours of exposure.

PEP should be started within 72 hours of exposure.

Renal and hepatic function tests should be done 6 weeks after beginning PEP.

   PEP will prevent potential hepatitis C infection if present.




Question 93.      The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x- ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane's description of her injury. Which of the following clues in Diane's examination or history would alert the clinician to the need for obtaining radiographs?

                Inability to bear weight immediately after the injury

Development of marked ankle swelling and discoloration after the injury

Crepitation with palpation or movement of the ankle


   All of the above              

Question 94.      A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods?

                  Rice  Carrots

   Spinach  Potatoes




Question 95.      A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which a?ected cranial nerve?

            CN II   CN III   CN IV   CN V




Question 96.      A patient presents to the clinician after experiencing four

episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?



   Cardiac arrhythmias   All of the above




Question 97.      Which test is used to confirm a diagnosis of epididymitis?


Gram stain of urethral discharge


Complete blood cell count with di?erential Ultrasound of the scrotum




Question 98.      BATHEing the patient refers to:

  A technique used in primary care to get the patient to accept the need for psychological or psychiatric referral

A technique used to facilitate cultural understanding

A technique used to perform psychotherapy

A technique that is a quick screen for psychiatric issues and interventions for psychological problems




Question 99.      BATHEing the patient is an advanced practice nursing intervention that allows the practitioner to:

Develop a therapeutic relationship without "owning" the patient's problem

Conduct psychological counseling within the context of the primary care encounter

Focus on the "process" and not the assessment

Make the patient and family happier     



Question 100.    A 45-year-old woman is seen in the clinic with abnormal

uterine bleeding and pain during intercourse. The clinician should consider which of the following diagnoses?



Ovarian cancer

All of the above



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